Clinical results of soft tissue reconstruction using arterialized venous free flap after resection of soft tissue tumor in the hand

In patients with hand tumors, advances in medicine have led to a preference for limb-sparing surgery that offers functional and aesthetic advantages. However, limb-sparing surgery often results in soft tissue defects after tumor resection. We present our clinical results using arterialized venous free flaps to reconstruct defects after soft tissue tumor resection. Four patients who underwent arterialized venous free flap for hand reconstruction after soft tissue tumor resection between June 2016 and July 2020 were retrospectively reviewed. Pathological causes of soft tissue tumors were malignant melanoma, synovial sarcoma, malignant giant cell tumor, and recurrent epidermoid cyst. Tumor locations included the palm of the hand in 2 cases, the dorsum of the hand in 1 case, and the right long finger (RLF) in 1 case. Donor sites included the distal volar aspect of the ipsilateral forearm was the donor site in 3 cases and the contralateral forearm was the donor site in 1 case. Pure venous skin flaps were used in 3 cases. Only one case used a composite tendocutaneous flap. Flaps survived well in all the patients. The mean follow-up period of the flaps was 41.75 ± 9.09 months. Recurrence or metastasis was not found, except in 1 case. Kaplan-Meier survival analysis was performed. Restricted mean survival time of metastasis/recurrence was 57.00 ± 12.99 months. The color and texture of the flap were satisfactory in all the patients. Donor-site complications were not observed in any patient. Thus, an arterialized venous free flap is considered a valuable reconstruction option after soft tissue tumor resection.